Barriers To Implementation Of Health Technology Assessment

ABSTRACT

Introduction. The transition from the budget model of the healthcare system to compulsory social health insurance has created a competitive environment among hospitals in Kazakhstan. Managers are interested in introducing the most effective new technologies. Implementation of the health technology assessment (HTA) process in Kazakhstan began in 2010 but few managers have created a structure for HTA development in their hospitals. Our aim was to identify issues in the implementation of new health technologies in hospitals. Methods. Structured interviews were held with hospital managers and physicians in June 2020, and September 2021. In the first stage, the needs of hospitals in the implementation of new technologies were considered. In the second stage, the impact of COVID-19 on the introduction of new technologies in the hospital was addressed. Interviews were held on-line by mobile phone or zoom and lasted 25-30 minutes. Results. The first interviews involved 8 managers and 14 physicians from 5 hospitals. The needs of HTA for physicians was noted by respondents of both groups. Only a few physicians had been trained in HTA. Hospital staff lacked time and experience in preparing applications for new technologies by a national assessment unit and could not meet deadlines. Managers were interested in use of HTA for hospitals' technologies in short-term timeframes within existing policies. However, physicians believed that long-term performance of technologies over 5 years or more should also be considered in hospital management. Physicians were aware of the importance of ethical considerations in the HTA of new health technologies. Managers did not consider ethical issues. At the second stage of the project, 5 managers and 8 physicians were interviewed. COVID-19 had shown the importance and necessity of developing the scientific potential of doctors, and of introducing HTA and training medical personnel in its use. Conclusions. Positive outcomes from the interviews were the interest of respondents in increasing their knowledge of the HTA process and acceptance of its importance at the hospital level.